title: Association between preoperative plasma sRAGE levels and recovery from cardiac surgery.
abstract: BACKGROUND
  The receptor for advanced glycation end products (RAGE) is an inflammation-perpetuating receptor, and soluble RAGE (sRAGE) is a marker of cellular RAGE expression. This study investigated whether raised plasma levels prior to surgery of sRAGE or S100A8/A9 (a RAGE ligand) were associated with longer duration of hospital care in patients undergoing cardiac surgery necessitating cardiopulmonary bypass.
  
  
  METHODS
  Patients (n = 130) undergoing elective cardiac surgery were enrolled prospectively. Plasma sRAGE and S100A8/A9 concentrations were measured before and 2 h after surgery.
  
  
  RESULTS
  Preoperative plasma sRAGE increased significantly (P < 0.0001) from 1.06 ng/mL (IQR, 0.72-1.76) to 1.93 ng/mL (IQR, 1.14-2.63) 2 h postoperatively. Plasma S100A8/9 was also significantly (P < 0.0001) higher 2 h postoperatively (2.37  μ g/mL, IQR, 1.81-3.05) compared to pre-operative levels (0.41  μ g/mL, IQR, 0.2-0.65). Preoperative sRAGE, but not S100A8/A9, was positively and significantly correlated with duration of critical illness (r = 0.3, P = 0.0007) and length of hospital stay (LOS; r = 0.31, P < 0.0005). Multivariate binary logistic regression showed preoperative sRAGE to be, statistically, an independent predictor of greater than median duration of critical illness (odds ratio 16.6, P = 0.014) and to be, statistically, the strongest independent predictor of hospital LOS.
  
  
  CONCLUSIONS
  Higher preoperative plasma sRAGE levels were associated with prolonged duration of care in adults undergoing cardiac surgery requiring cardiopulmonary bypass.
authors.affiliation: Unit of Critical Care, Respiratory Science, National Heart and Lung Institute Division (NHLI), Faculty of Medicine, Imperial College London, Dovehouse Street, London SW3 6LY, UK ; NIHR Respiratory Disease Biomedical Research Unit, Royal Brompton and Harefield NHS Foundation Trust, London SW3 6NP, UK.
authors.forename: Benedict C
authors.initials: BC
authors.lastname: Creagh-Brown
authors.forename: Gregory J
authors.initials: GJ
authors.lastname: Quinlan
authors.forename: Lauren R
authors.initials: LR
authors.lastname: Hector
authors.forename: Timothy W
authors.initials: TW
authors.lastname: Evans
authors.forename: Anne
authors.initials: A
authors.lastname: Burke-Gaffney
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000378:metabolism; D006348:Cardiac Surgical Procedures; D002315:Cardiopulmonary Bypass; D005260:Female; D005786:Gene Expression Regulation; D006331:Heart Diseases / Q000097:blood* / Q000601:surgery; D006801:Humans; D007902:Length of Stay; D008024:Ligands; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D057234:Preoperative Period; D011446:Prospective Studies; D000067759:Receptor for Advanced Glycation End Products; D011971:Receptors, Immunologic / Q000097:blood*; D012306:Risk; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D008024:Ligands; D000067759:Receptor for Advanced Glycation End Products; D011971:Receptors, Immunologic